As sporting standards improve, the intensity of training methods increase accordingly. Amateur sportsmen may train as much as the top professionals did a decade ago with little rest to enable the body to recover from the fatigue which results from hard training. As training builds up progressively, a point is reached where the body is no longer able to fully recover between sessions, resulting in a levelling off and eventually a decline in performance.

Symptoms of incomplete recovery:

1. Muscle pain
2. Joint pain
3. Tendon inflammation
4. Restlessness and difficulty sleeping due to pain.

When the musculoskeletal system is being overtrained it becomes vulnerable to trauma. Whilst following a seemingly normal training schedule one could suffer acute conditions like:

1. Severe muscle strain
2. Joint sprains
3. Stress fractures.

Prevention of over training injuries:

1. Allow enough rest time between training sessions to allow the body to recover fully
2. Implement a warming down and stretching program as part of the training schedule.
3. Sports massage to work individual muscle units.

Function of sports massage:

Muscle groups are divided into many sub-compartments, each of which contract with different effort to produce the complexity of movement required. Although stretching is effective in working the muscle groups as a whole, it does not work the individual muscles that may require further treatment to prevent injury. Stretching may also be limited by the normal range of motion of some joints, thus preventing a full stretch of a muscle.

The effects of sports massage

1. Mechanical effects:
2. Friction warming
3. Pumping the circulation
4. Stretching soft tissue
5. Breaking scar tissue
6. Breaking adhesions
7. Increased tissue permeability
8. Opening microcirculation
9. Enzyme release
10. Improved tissue elasticity.
11. Relaxation
12. Pain reduction

Friction warming

Hands sliding along the skin cause friction which creates much of the heat derived from massage. Friction also occurs between all the tissue layers as they are moved against each other, which generates more heat. Some heat is formed by the opening of the arteries and capillaries through the pumping effect and the axonal reflexes caused by massage stimulation. The improvement in the microcirculation brings more warm blood to the superficial layers. The release of intracellular enzymes like histamine will also create some heat. These warming effects are beneficial as they increase the pliability of the tissues and improve metabolism.

Pumping the circulation

Every stroke made along the flow of the venous and lymphatic systems assists their circulation. As massage is applied it causes increased pressure in the vessels in front of the stroke and a subsequent vacuum in those behind. Both these pressure changes assist the flow of fluid in the venous and lymphatic vessels and will make room for new fluids coming from deeper tissues. Increase in the return flow will obviously improve arterial blood supply which has to refill the cleared vessels. When muscles are tense or there is increased pressure in the muscle compartments, the circulation within the involved muscle is inhibited which also results in impaired circulation to the associated joints, ligaments and tendons. As blood is rich in oxygen and other substances vital for repair and growth, the pumping effect achieved with massage is essential to restore normal tissue function.

Increased tissue permeability

Deep stroking massage techniques create a localised increase in pressure, which causes the pores in tissue membranes to open, facilitating the exchange of fluids. It improves the removal of muscle waste like lactic acid, which builds up in the muscles during and immediately after hard exercise. The highly oxygenated fluids rich in nutrients are then absorbed more easily.

This is necessary to normalise tissue metabolism and to facilitate the repair and build-up of tissues following training. As a result of increased tissue permeability, one can measure the increase of tissue enzyme levels in the blood after massage.

Stretching

Massage techniques can achieve stretching of muscles, tendons and fascia. In addition massage can stretch those other tissues that cannot be reached by any other method. While normal stretching exercises stretch the muscle group as a whole, massage is more specific and treats individual muscles. With stretching the muscle attachments are drawn away from each other, causing fibres to lengthen and the muscle bundles are brought closer together. With massage, the muscle bundles are pulled longitudinally and are moved transversely. This both stretches the fibres and moves the bundles apart thereby improving intramuscular circulation and breaking possible adhesions between the muscle bundles. Massage has the added advantage of being able to stretch muscles regardless of joint range while conventional stretching is often restricted by the limitation of normal or restricted joint movement. With massage it is possible to stretch fascia (unlike normal stretching which affects all the structures in the general area) which releases muscle tension and is of particular importance in compartment syndrome where tense fascia causes increased intrafascial pressure.

Breaking down scar tissue

Scar tissue, due to past injuries or gradual build-up of overuse injuries due to repeated microtrauma, may be present in soft tissue like muscle, tendons and ligaments. Adhesions may occur where fibrous tissue causes different tissues to stick together due to inflammation or microtrauma reducing the tensile strength of the tissues and restricting movement. Deep friction massage is used to break down scar tissue and adhesions resulting in the return of normal tissue tension, restoration of contractile properties and a normal range of motion.

Improved tissue elasticity

Excessive repetitive and long-standing isometric contractions of muscle results in hard and inelastic tissues. This in turn negatively impacts on tissue metabolism resulting in tissue wasting and replacement by fibrotic and less elastic tissues. By kneading soft tissues it is possible to pull elastic structures to near their maximal length in all directions. This is necessary to maintain normal elasticity in tissues which are continually put under great stress in certain positions.

Opening micro-circulation

Massage increases the total blood flow through the treated part by opening the aterioles and capillaries improving the exchange of fluids to the tissues. Deep massage causes the release of vasoactive substances which dilates the vessels bringing new fluid to the tissues.

Pain reduction

Intensive muscle training results in excessive muscle tension which restricts circulation and deprives the tissues of oxygen. Metabolic waste products accumulate in these tissues resulting in pain. The mechanical effects of massage will reduce pain by increasing circulation and flushing out the metabolites. Massage is able to reduce pain by reflexes affecting the central nervous system which release endorphins which reduces the brains ability to ‘feel’ pain by attaching to the pain receptors. Massage also reduces pain by stimulating the mechanoreceptors in the skin and muscle which ‘over-ride’ the pain signal originating from the same tissues at the dorsal horn of the spinal cord. Thus the brain will register a ‘touch’ sensation and not the ‘pain’ sensation. This is called the ‘Gate Control Theory’.

Direction of Massage

 Massage should be directed towards the heart when treating extremities. Reasons for massage direction:

1. Assist lymphatic and venous flow.
2. Remove waste product from tissues.
3. Shorten recovery time.
4. If massage is applied in opposite direction, the valves of lymphatic vessels and superficial veins could be damaged.

Superficial Stroking (Effleurage)

• Warms area up

Longitudinal Stroking

• Best technique for stretching the muscle.
• Can work on small areas affected by local tension.
• Induces local relaxation.
• Facilitates removal of muscle waste.

Transverse Stroking

• Mainly used as a diagnostic technique to locate bands of muscles.

Kneeding (Petrissage)

• Helps circulate blood and tissue fluids thus speeding up recovery.
• Creates movement between muscle bands, improving elasticity and flexibility.

Squeezing

• Creates transverse movement between deep layers of muscle tissue, different muscles and between muscle and bone.

Deep friction

• Breaks down scar tis-sue.
• Prevents build-up of scar tissue.
• Promotes formation of elastic fibrous tissue.
• Breaks down adhesions.
• Stimulates local blood supply.

The effects of sports massage

Mechanical effects

1. Friction ( warming)
2. Pumping the circulation
3. Increased tissue permeability
4. Stretching soft tissue
5. Breaking (scar tissue/ adhesions)
6. Improved tissue elasticity
7. Opening micro-circulation
8. Enzyme release

Reflectory effects

1. Pain reduction
2. Relaxation
3. Balancing autonomous nervous system